Advocating an attack against severe malaria: a cost-effectiveness analysis.

Area of Science:

• Mathematical modeling
• Public health interventions
• Microbiome research

Background:

• Gut microbiota, including Lactobacillus and Bifidobacterium, can modulate malaria severity.
• Current malaria interventions do not typically focus on microbiota-mediated modulation.
• Predicting health benefits and cost-effectiveness is crucial for microbiota-targeted interventions.

Purpose of the Study:

• To evaluate the cost-effectiveness of interventions targeting reduced severe malaria incidence.
• To model malaria transmission dynamics and potential benefits of microbiota-based interventions.
• To assess health gains and economic viability across various reduction scenarios.

Main Methods:

• Developed a mathematical model of malaria transmission.
• Simulated intervention scenarios for 2-, 7-, and 14-fold reductions in severe malaria incidence.
• Estimated disability-adjusted life years averted and cost-effectiveness ratios using country-specific data for 41 sub-Saharan African countries.

Main Results:

• Interventions reducing severe malaria 14-fold, costing $23.65-$30.26/person/year, are cost-effective in 15-19 countries and very cost-effective in 9-14.
• Microbiota distribution via low-cost ($0.20/serving) freeze-dried yogurt makes interventions cost-effective in 29 countries and very cost-effective in 25 for 2- to 14-fold reductions.
• Even limited reductions in severe malaria incidence yield substantial health benefits and economic viability.

Conclusions:

• Interventions targeting severe malaria are cost-effective adjuncts to standard treatments, reducing malaria's health burden and costs.
• Greater reductions in severe malaria incidence correlate with stronger cost-effectiveness.
• Even modest reductions in severe malaria incidence offer significant health benefits and economic viability, meriting further research.